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General NPI Number Information
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NPI Number | 1174913404
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Entity Type | Organization
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Legal Business Name | DR. ROLAND YAKUBOV PROFESSIONAL DENTAL INC
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Dates
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Enumeration Date | 01/26/2015
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Last Update Date | 11/22/2025
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Provider Practice Location Address
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Address Line | 8041 FOOTHILL BLVD
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City | SUNLAND
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State | CA
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Zip | 91040-2957
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Country | US
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Telephone | 818-726-8534
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Fax |
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Provider Business Mailing Address
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Address Line | 8041 FOOTHILL BLVD
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City | SUNLAND
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State | CA
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Zip | 91040-2957
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | ROLAND YAKUBOV
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Credential | DMD
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Telephone | 818-726-8534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 57064
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License Number State | CA
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